TRI-STATE WEBINAR SERIES

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1 TRI-STATE WEBINAR SERIES Sensory 101: Understanding Sensory Differences Presented by: Cara Woundy, M.Ed, CAGS, OTR/L Jamie Lewis, M.S. OTR/L Tri-State Autism Spectrum Disorder Webinar Series This material was developed under a grant from the Colorado Department of Education. The content does not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government. The content of this material was developed under an agreement from the Federal Department of Education to the Kansas Department of Education. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Kansas Department of Education or the Federal Government. TASN Autism and Tertiary Behavior Supports does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Deputy Director, Keystone Learning Services, 500 E. Sunflower, Ozawkie, KS 66070, The contents of this power point presentation were developed under a grant from the Nebraska Department of Education, IDEA parts B and C from the U.S. Department of Education. However, this content does not necessarily represent the policy of the U.S. Department of Education and you should not assume endorsement by the Federal Government. 1

2 Questions will be asked throughout the webinar Polling Questions When the poll opens on your screen respond by clicking on or filling in your answer Presenter Information Cara Woundy M.Ed., CAGS, OTR/L Occupational Therapist and School Psychologist Autism Specialist Colorado Department of Education Jamie Lewis, M.S.OTR/L Occupational Therapist Central Region Autism Spectrum Disorders Team Nebraska ASD Network 2

3 Learner Objectives The participant will become familiar with the various sensory systems. The participant will be able to understand types of sensory differences. The participant will identify strategies that help with various sensory differences. Presentation Summary This webinar will provide an overview of sensory systems and how differences manifest. Participants will learn common terminology, which will allow them to understand and discuss sensory differences when working with students, teachers, administrators and parents. Sensory supports and strategies within the school and home environments will also be highlighted. 3

4 OUR SENSES Let s review 8 4

5 Why is this important? The way an individual processes and responds to sensation has an impact on their daily life activities and activity choices. (Zuckerman, 1994, & Dunn, 1997) Atypical sensory processing refers to both hyper and hypo reactivity to sensation. Poor or atypical sensory processing abilities have been associated with problems in social participation and behavioral self-regulation, as well as learning, leisure, and occupational activities. (Dunn, 2001) 10 8 Sensory Systems FAR SENSES -Environmental Senses Sight-Visual Hearing-Auditory Taste-Gustatory Smell-Olfactory Touch-Tactile 2 types: defense (protect from danger) exploration (learning and discrimination) 5

6 Sight/Visual System This system deals with acuity and perception. These may be seen in children with visual challenges: Head Tilt Squinting Red/watery eyes Fixation Decreased Attention to task Flicking toys or hands in front of eyes Looking at objects out of the corner of the eyes 11 Hearing/Auditory This system is responsible for hearing acuity. Children with an altered auditory system may: Be hyper-sensitive to sound. Be hypo-responsive to sound. Have an inability to filter background noise. Appear stressed in noisy environments Appear withdrawn in noisy environments 12 6

7 Taste/Gustatory This system works closely with smell. Some children with taste/gustatory challenges may: Object to certain textures or temperatures of food. Gag at the sight or taste of certain foods. Prefer to lick or smell foods prior to eating them. Lick or taste inedible objects. Prefer high sensory-value food (chips, salsa, candy, pop) 13 Smell/Olfactory This system helps to establish and revive memories. Works very closely with taste. Some children with smell differences may: Object to odors that other children would not notice. Sniff food, people, and objects. 14 7

8 Tactile The tactile sense provides information, primarily through our skin, about the texture, shape and size of objects in the environment. It helps us distinguish between threatening and nonthreatening touch sensations. Function: Protective: to alert the organism Discriminative: to give information about the environment when the body makes contact with it 15 NEAR SENSES -Body Centered Senses Vestibular Proprioceptive Interoception 8

9 Vestibular The vestibular sense provides information through the inner ear about gravity and space, about balance and movement, and about our head and body position in relation to the surface of the earth. 17 Proprioceptive The proprioceptive sense provides information through our joints, muscles, ligaments, and deep in our skin about where our body parts are and what they are doing. 18 9

10 An 8 th Sensory System: Interoception Interoception provides us with feedback from our body s organs. It refers to the awareness of our body s internal signals. Helps us answer the question, How am I doing? This system is responsible for telling us when we feel hungry or tired. Sensory Integration Sensory Integration is a theory of brain-behavior relationships The term Sensory Integration was developed by A. Jean Ayres PhD, OTR 20 10

11 Active Student Responding A student that swings every day at recess enjoys the following sensory input: A. Vestibular B. Proprioception C. Interoception D. Tactile Active Student Responding A student that swings every day at recess enjoys the following sensory input: A. Vestibular B. Proprioception C. Interoception D. Tactile 11

12 OBSERVING SENSORY RESPONSES Sensory Processing Disorder SPD SPD is sometimes called Sensory Integrative Dysfunction (or SID). SPD is the inability to respond appropriately to ordinary experiences. It occurs when the brain processes sensations inefficiently. Since we cannot see inside the brain, we rely on behavioral responses to indicate how a person is responding to sensory information

13 Behavior Because we are looking at RESPONES to sensory input, we are also talking about behavior. Remember, behavior is anything a person does that is observable and measurable. Almost everything that we do can be described as behavior. Active Student Responding If you see a student jumping up and down in the classroom, he probably is: A. Excited B. Trying to get an adults attention C. Obtaining proprioceptive input D. I need more information 13

14 Active Student Responding If you see a student jumping up and down in the classroom, he probably is: A. Excited B. Trying to get an adults attention C. Obtaining proprioceptive input D. I need more information Analyzing the Behavior 28 Always a reason for behavior: 14

15 The ABCs 29 Antecedent what promoted the behavior immediately before the behavior Behavior define and look for link: in response to same situation or occur in predictable pattern Consequence-what happened immediately after the behavior A-B-C Loud and Crowded Cafeteria Adult walks student back to classroom to eat lunch there Student stops at door of cafeteria and refuses to walk in 15

16 When should we observe? MAS Scoring Rubric 16

17 Free checklists Knowing the Difference 34 Sensory processing disorders can be misconstrued as behavioral problems, inattention, distractibility, motor incoordination, hyperactivity, or emotional difficulties. If we only address the behavioral aspect of the problem, the base sensory problem will still exist. (Murray-Slutsky & Paris, 2005) 17

18 Avoid Sensory Stimulation Back to class Behavioral Outburst Break SENSORY DIFFERENCES 18

19 Sensory Processing Disorder Subtypes Sensory Modulation Disorder Sensory Over-Responsive Sensory Under-Responsive Sensory Craving SENSORY OBTAINING Under-responsive and craving responses 19

20 Sensory Obtaining Behaviors Child who is under-responsive will often display seeking or obtaining behaviors Tactile input: repeatedly touch and feel objects, bump into things, show little reaction to pain, shake hands, rub skin, pick skin, mouth objects Proprioceptive input: climbing, running, jumping, crashing, rough-housing, pinching, hitting, chewing, motor planning difficulties Auditory input: humming, whistling, vocal play, shrieking, grinding teeth, flicking/pulling ears Interoception input: Not enough input from their internal organs can result in not knowing when they have to use the toilet or register the sense of hunger or thirst Intervention Principles -- Obtaining Sensory modulation difficulties in the areas of under-responsive and sensory seeking/craving will often be those behaviors that are identified as obtaining. Sometimes responses can be productive and acceptable. We don t need to change that response. We need to help others understand purpose. (Murray-Slutsky & Paris, 2005) 20

21 Sensory Obtaining Strategies Use alerting, fast, irregular and intense input to increase arousal Use high intensity sensations to increase responsivity (light touch, varied movement, colors and patterns) Use taste, food textures and smells Find sensory activities that are motivating Use self and activities that invite child to want to participate (facial expression and affect) Use movement games with varied positions and quick changes in speed, direction and position (esp. antigravity) Proprioceptive prep with a movement component 41 Practical Ideas for the Obtainer Time to work the body ; trampoline, running, P.E., running purposeful errands (10-20 min. per 2 hours) Wheelies on shoes for transitions Fidgets for seat work; scented markers/pens Alerting gums and candies Arrhythmic music; headphones with music during study Stability ball, rocker chair, stand-up desk Allow standing or floor sitting during work tasks Consider study buddy to cue student to clues in environment 42 21

22 Practical Ideas-Obtainer (continued) Create organized movement experiences that are goaldirected and purposeful Use sensory and self-regulation programs that incorporate heavy work and purposeful tasks with deep proprioceptive components Use environmental modifications (artificial boundaries) Always have student participate in set-up and clean-up Enclosed or small spaces control activity Start and stop activities Sensory backpacks or Roos with fidgets and mouth tools Assign jobs---short but many (trash out, wipe board, etc.) 43 SENSORY AVOIDING Over-responsive 22

23 45 Sensory Avoiding Behaviors A child who is over-responsive will often display avoidance behaviors. Vestibular input: child may avoid playground activities, get car sick, move slowly for fear of falling even with no real threat. Tactile input: respond negatively to light or unexpected touch, may be picky about clothing, food, may crave deep touch/pressure, may hate haircuts, dentist, brushing teeth, walking barefoot or toe walking Auditory input: stressed in noisy environments, humming, singing, self-talk, head banging Multisensory input: easily overstimulated, overaroused: when bombarded by multiple senses Intervention Principles-Avoiding 46 Avoidance due to over-responsive sensory system Identify elements contributing to overload (sensory, environmental, schedule) (Murray-Slutsky & Paris, 2005) 23

24 Sensory Avoiding Strategies Identify appropriate sensory-based activities effective in calming or organizing Teach use of alternative activities for calming Teach to I.D. warning signs of overload and use activities Integrate calming sensory activities throughout the day Teach to recognize and communicate feelings Systematically increase tolerance for and scope of new activities Practical Strategies- Avoider Have child administer sensation to self Gradually introduce new/different sensations Heavy work helps to calm over-arousal Predictability builds trust, never surprise a child with SOR; provide advance notice Avoid sensory events at times, but slowly expose child to these sensations when possible Structure environment and tasks to minimize overreactions Use calming activities (deep touch pressure with engagement, proprioceptive input) 48 24

25 Practical Ideas for the Avoider Gentle stimulation or decreasing input Consider a time in place for regrouping that is not punitive (Henry s Quiet and Buddy Spaces) Weighted or heavy backpack during hallway transitions Slow rhythmic music Resistance bands Wall push ups Aroma bracelet (lavender, chamomile, vanilla) Pressure garment under clothing Gum or resistance candy/foods Headphones (noise-cancelling), hat, sunglasses Buddy rather than group projects 49 Active Student Responding You observed a student and discovered that he withdraws from touch. Your intervention strategy will be: A. Ask his peers to touch him during the day so he gets desensitized. B. Recommend parents sign him up for football. C. Teach advocacy skills. D. Use alerting, fast, irregular and intense input to increase arousal. 25

26 Active Student Responding You observed a student and discovered that he withdraws from touch. Your intervention strategy will be: A. Ask his peers to touch him during the day so he gets desensitized. B. Recommend parents sign him up for football. C. Teach advocacy skills. D. Use alerting, fast, irregular and intense input to increase arousal. Conclusion Sensory responses are behaviors we need to better understand for appropriate intervention. Once we determine the function of the behavior is sensory in nature, we can better help the student cope with processing the information correctly or change the environment. There are a variety of strategies that can be used to help modulate a student s response to sensory information, once we determine if the function is an avoidance or obtaining behavior. 26

27 THANK YOU! Cara Woundy Jamie Lewis 54 References Winnie Dunn, Ph.D, OTR, FAOTA Sensory Processing in Everyday Life: Evidence Based Strategies, Hays, KS 6/11-12/2007 Diana Henry, OT Tool Chest for Teachers, Parents and Students Nancy Kashman, LOTR & Janet Mora, MA, CCC-SLP An OT and SLP Team Approach: Sensory and Communication Strategies that Work! Carol Kranowitz, M.A. The Out of Sync Child The Out of Sync Child Has Fun Common Questions Teachers Ask about SI Luci J. Miller, OT A Sensitive Subject online newsletters The Source, Autism Information in Colorado, July 2006 Sensational Kids: Hope and Help for Children with Sensory Processing Disorder, April 2006 Sensory Strategies to Improve Children s Learning and Behavior, Lincoln, NE 10/25/2007 Carolyn Murray-Slutsky, MS, OTR & Betty A. Paris, PT, M.Ed. Is It Sensory or Is It Behavior? Behavior Problem Identification, Assessment, and Intervention Mary Sue Williams & Sherry Shellenberger How Does Your Engine Run? The Alert Program for Self-Regulation 27